IDEAS home Printed from https://ideas.repec.org/a/nat/natcom/v15y2024i1d10.1038_s41467-024-51428-0.html
   My bibliography  Save this article

An unusual two-strain cholera outbreak in Lebanon, 2022-2023: a genomic epidemiology study

Author

Listed:
  • Antoine Abou Fayad

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Rayane Rafei

    (Lebanese University)

  • Elisabeth Njamkepo

    (Centre National de Référence des vibrions et du choléra)

  • Jana Ezzeddine

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Hadi Hussein

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Solara Sinno

    (World Health Organization)

  • Jose-Rita Gerges

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Sara Barada

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Ahmad Sleiman

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

  • Moubadda Assi

    (World Health Organization)

  • Maryo Baakliny

    (Ministry of Public Health)

  • Lama Hamedeh

    (American University of Beirut)

  • Rami Mahfouz

    (American University of Beirut)

  • Fouad Dabboussi

    (Lebanese University)

  • Rita Feghali

    (Rafik Hariri University Hospital)

  • Zeina Mohsen

    (Rafik Hariri University Hospital)

  • Alisar Rady

    (World Health Organization)

  • Nada Ghosn

    (Ministry of Public Health)

  • Firas Abiad

    (Ministry of Public Health)

  • Abdinasir Abubakar

    (World Health Organization)

  • Amal Barakat

    (Eastern Mediterranean Regional Office Cairo)

  • Nadia Wauquier

    (World Health Organisation)

  • Marie-Laure Quilici

    (Centre National de Référence des vibrions et du choléra)

  • Monzer Hamze

    (Lebanese University)

  • François-Xavier Weill

    (Centre National de Référence des vibrions et du choléra)

  • Ghassan M. Matar

    (American University of Beirut
    American University of Beirut
    World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens)

Abstract

Cholera is a life-threatening gastrointestinal infection caused by a toxigenic bacterium, Vibrio cholerae. After a lull of almost 30 years, a first case of cholera was detected in Lebanon in October 2022. The outbreak lasted three months, with 8007 suspected cases (671 laboratory-confirmed) and 23 deaths. In this study, we use phenotypic methods and microbial genomics to study 34 clinical and environmental Vibrio cholerae isolates collected throughout this outbreak. All isolates are identified as V. cholerae O1, serotype Ogawa strains from wave 3 of the seventh pandemic El Tor (7PET) lineage. Phylogenomic analysis unexpectedly reveals the presence of two different strains of the seventh pandemic El Tor (7PET) lineage. The dominant strain has a narrow antibiotic resistance profile and is phylogenetically related to South Asian V. cholerae isolates and derived African isolates from the AFR15 sublineage. The second strain is geographically restricted and extensively drug-resistant. It belongs to the AFR13 sublineage and clusters with V. cholerae isolates collected in Yemen. In conclusion, the 2022-2023 Lebanese cholera outbreak is caused by the simultaneous introduction of two different 7PET strains. Genomic surveillance with cross-border collaboration is therefore crucial for the identification of new introductions and routes of circulation of cholera, improving our understanding of cholera epidemiology.

Suggested Citation

  • Antoine Abou Fayad & Rayane Rafei & Elisabeth Njamkepo & Jana Ezzeddine & Hadi Hussein & Solara Sinno & Jose-Rita Gerges & Sara Barada & Ahmad Sleiman & Moubadda Assi & Maryo Baakliny & Lama Hamedeh &, 2024. "An unusual two-strain cholera outbreak in Lebanon, 2022-2023: a genomic epidemiology study," Nature Communications, Nature, vol. 15(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-51428-0
    DOI: 10.1038/s41467-024-51428-0
    as

    Download full text from publisher

    File URL: https://www.nature.com/articles/s41467-024-51428-0
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1038/s41467-024-51428-0?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ankur Mutreja & Dong Wook Kim & Nicholas R. Thomson & Thomas R. Connor & Je Hee Lee & Samuel Kariuki & Nicholas J. Croucher & Seon Young Choi & Simon R. Harris & Michael Lebens & Swapan Kumar Niyogi &, 2011. "Evidence for several waves of global transmission in the seventh cholera pandemic," Nature, Nature, vol. 477(7365), pages 462-465, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sadie J. Ryan & Anna M. Stewart-Ibarra & Eunice Ordóñez-Enireb & Winnie Chu & Julia L. Finkelstein & Christine A. King & Luis E. Escobar & Christina Lupone & Froilan Heras & Erica Tauzer & Egan Waggon, 2018. "Spatiotemporal Variation in Environmental Vibrio cholerae in an Estuary in Southern Coastal Ecuador," IJERPH, MDPI, vol. 15(3), pages 1-13, March.
    2. Alyce Taylor-Brown & Mokibul Hassan Afrad & Ashraful Islam Khan & Florent Lassalle & Md. Taufiqul Islam & Nabid Anjum Tanvir & Nicholas R. Thomson & Firdausi Qadri, 2023. "Genomic epidemiology of Vibrio cholerae during a mass vaccination campaign of displaced communities in Bangladesh," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    3. Chrispin Chaguza & Innocent Chibwe & David Chaima & Patrick Musicha & Latif Ndeketa & Watipaso Kasambara & Chimwemwe Mhango & Upendo L. Mseka & Joseph Bitilinyu-Bangoh & Bernard Mvula & Wakisa Kipandu, 2024. "Genomic insights into the 2022–2023Vibrio cholerae outbreak in Malawi," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
    4. Md Mamun Monir & Mohammad Tarequl Islam & Razib Mazumder & Dinesh Mondal & Kazi Sumaita Nahar & Marzia Sultana & Masatomo Morita & Makoto Ohnishi & Anwar Huq & Haruo Watanabe & Firdausi Qadri & Mustaf, 2023. "Genomic attributes of Vibrio cholerae O1 responsible for 2022 massive cholera outbreak in Bangladesh," Nature Communications, Nature, vol. 14(1), pages 1-8, December.
    5. Amy Marie Campbell & Ronnie G. Gavilan & Michel Abanto Marin & Chao Yang & Chris Hauton & Ronny Aerle & Jaime Martinez-Urtaza, 2024. "Evolutionary dynamics of the successful expansion of pandemic Vibrio parahaemolyticus ST3 in Latin America," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
    6. Yun Luo & Michael Payne & Sandeep Kaur & Sophie Octavia & Ruiting Lan, 2024. "Genomic evidence of two-staged transmission of the early seventh cholera pandemic," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    7. Tomomichi Ogata & Marie-Fanny Racault & Masami Nonaka & Swadhin Behera, 2021. "Climate Precursors of Satellite Water Marker Index for Spring Cholera Outbreak in Northern Bay of Bengal Coastal Regions," IJERPH, MDPI, vol. 18(19), pages 1-15, September.
    8. Caitlin S Pepperell & Amanda M Casto & Andrew Kitchen & Julie M Granka & Omar E Cornejo & Eddie C Holmes & Bruce Birren & James Galagan & Marcus W Feldman, 2013. "The Role of Selection in Shaping Diversity of Natural M. tuberculosis Populations," PLOS Pathogens, Public Library of Science, vol. 9(8), pages 1-14, August.
    9. Thandavarayan Ramamurthy & Agila Kumari Pragasam & Alyce Taylor-Brown & Robert C. Will & Karthick Vasudevan & Bhabatosh Das & Sunil Kumar Srivastava & Goutam Chowdhury & Asish K. Mukhopadhyay & Shanta, 2022. "Vibrio cholerae O139 genomes provide a clue to why it may have failed to usher in the eighth cholera pandemic," Nature Communications, Nature, vol. 13(1), pages 1-10, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-51428-0. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.nature.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.